50   No. 41970 GOVERNMENT GAZETTE, 12 OCTOBER 2018 B0000000001 PART H H1. PREVIOUS CORRECTIONS OR ALTERATIONS TO APPLICANT’S PARTICULARS Please indicate any previous corrections or alterations to the applicant’s particulars (i.e. surname, forename, date of birth, gender) or any changes to such particulars of the applicant’s parents Previous particulars Particulars after correction or alteration Date corrected or altered Reason for correction or alteration DECLARATION We declare under oath/solemnly that the particulars given above are to the best of our knowledge and belief true and correct. We understand that a false statement is punishable under section 31(1) of the Births and Deaths Registration Act 51 of 1992. Signature of father Signature of mother COMMISSIONER OF OATHS 1. I certify that before administering the oath/affirmation, I asked the deponents the following questions and wrote their answers in their presence: a) Do you know and understand the contents of this declaration? Father Mother b) Do you have any objection to taking the prescribed oath? Father Mother c) Do you consider the prescribed oath to be binding on your conscience? Father Mother 2. I certify that the deponents have acknowledged that they know and understand the contents of this declaration which was sworn to/affirmed before me and the deponents’ signatures and thumbprints were placed thereon in my presence. ...................................................................................................... Signature of informant Surname Forenames Business address ...................................................................................................... Commissioner of Oaths ...................................................................................................... Designation (Rank) Office Stamp H2. FOR OFFICIAL USE ONLY - HEAD OFFICE RECOMMENDATION Recommended Not Recommended : Reason Surname Forenames in full User ID Date Signature DECISION Y Y Y Y M M M M M M M M M D D Y Y Y M M M M M M M M M D D Rank Approved Refused: Reason Surname Forenames in full User ID Date Signature Y Rank Page 10 of 10 This gazette is also available free online at www.gpwonline.co.za